Do Doctors Disrespect Patients?

It’s bad enough that many patients leave hospitals with sutures, a bag of pain pills, and a new diagnosis that often carries a “chronic” prognosis. But, according to Harvard professor Lucian Leape, something even more insidious is happening that’s leaving patients with a bad taste in their mouths. He says, “Disrespectful behavior – our ability to tolerate it, and not do anything about it – is the root cause of the dysfunctional culture we have in medicine.”

In many of my blog posts, I’ve been suggesting that the only way we’re going to heal health care is to reclaim medicine’s heart and bring love back to the healing process. So I agree with Leape. Disrespect simply isn’t loving – and it runs rampant in hospital cultures.

Disrespect In Hospitals Runs Rampant

In a pair of papers published in July in the journal Academic Medicine, Leape and his co-authors outlined six categories of disrespect prevalent in hospitals. On one end lies the overtly nasty: the surgeon who throws the bloody scalpel across the OR, the four-letter outbursts, the bullying. More common is the systematic degradation and humiliation of medical students and residents by medical school professors, the contempt dripping from the voice of surgeons as they give orders to nurses, and the way some physicians demoralize and disrespect patients by cutting them off, negating what they say, or simply not listening.

But there are other more insidious behaviors of disrespect that permeate hospital culture: passive-aggression (harshly criticizing colleagues with the intent of psychologically harming them), passive disrespect born of apathy and burnout (“I won’t even bother to return this page from the nurse”), and dismissive treatment of patients (refusing to return their calls or answer their questions).

The final category may be the most disturbing because it’s so ingrained in hospital culture. Leape and his co-authors refer to this as the systemic disrespect that’s baked into the profession, which is all tied up in ego and superiority and fear of being outed as imperfect. It’s why many doctors who make inevitable mistakes won’t admit error for fear of malpractice suits. It’s why doctors keep patients waiting for hours on end without apologizing. It’s why physicians work excessive hours without taking into account that lack of sleep might actually harm the patient. It’s why some doctors start acting like – even believing – that they are Superhuman gods worthy of worship, not fallible humans like all the rest of us.

When doctors work all night, Leape said in this article, “They’re more likely to hurt somebody. And so you are deliberately putting them in a position where they may hurt somebody. And that’s very disrespectful.”

One Patient’s Story

One patient, a kidney/pancreas transplant recipient, was checking her own lab results when she noticed that some of her lab values were out of whack, suggesting that she might be in the early stages of transplant rejection. Nobody had called to alert her, so she called her doctor’s office but had trouble reaching anyone. Someone finally told her she could come to the office to see the doctor, but that she might have to wait.

So she came and waited, and waited, and waited–all day long.

Nobody every gave her a status update or suggested she might take a lunch break. The doctor never came to apologize or let her know he was doing everything he could to get to her as soon as possible. There was no nurse holding her worried hand or even front desk attendant keeping her in the loop. When she finally saw the doctor at the end of a long day, nobody apologized for failing to notice the abnormal lab values. Nobody acknowledged that she had been waiting for an entire day. Her doctor was in and out before she even got her questions answers. She wound up feeling worthless, helpless, disempowered, and patently disrespected, in addition to feeling anxious that her body might be rejecting her transplants. When she told me this story, she wound up crying hot tears of frustration and humiliation.

Is this how we want our sick patients to feel when they’re already scared, worried, and not feeling well?

The Antidote

So what can we do? How can we bring respect back to the hospital and clinic settings?

It’s going to require a shift of consciousness. As health care providers, we need to remember that we are all humans with equal power and equal rights. Each of us is equally deserving of respect and compassion, whether we’re patients or scrub techs or nurses or med students or doctors. Nobody is “better” than anyone else, and nobody deserves to be relegated to “lesser” status.

This means recognizing this for ourselves. Why should med students stand for abusive treatment? Why do patients allow themselves to be disrespected? Why do nurses grin and bear it when doctors get nasty? Why do doctors think they’re all that?

It all comes back to love. When we remember that our jobs as health care providers give us the opportunity to be true healers, we can reclaim the heart of medicine and choose to treat each other with love and mutual respect. It’s no wonder patients don’t get better when they wind up feeling disrespected. And it’s no wonder so many health care providers are miserable.

This is no way to live. And it’s certainly no way to heal.

Have You Ever Felt Disrespected?

Tell us your stories. Offer your suggestions. How can we bring respect back to health care?

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81 comments

(sorry about the length there -- anyway, suffice it to say that overall, it's been a grueling experience with that particular department and I'm quietly looking for an alternative after yet another incident last week.)

The kptx patient who noticed abnormal lab values and felt disrespected could easily have been me, except for a few minor differences in detail.

After 8 years seeing Transplant and Nephrology at an institution, I've had three excellent doctors and one excellent nurse, but also two very disrespectful docs and quite a few nurses who haven't treated me well, have miscommunicated information (in both directions, and criticized me for following other staff members' incorrect information. Occasional requests for another look at lab results, or for retests, have often been treated as signs of disrespectful behavior on MY part rather than a sign that I'm looking out for my own health and aware that even the best doctors are humans who can't catch everything 100%.

I've been yelled at by doctors for asking about possible medication changes, lectured on why I shouldn't call after hours even when the package insert said my symptom was an emergency situation, disbelieved when I reported medication side effects accurately, treated impatiently when I've asked questions, and dozens more incidents that leave me dreading my appointments.

When I've had good doctors there, they've been able to buffer a lot of the nursing staff's antics. Those doctors have provided good feedback, some sort of reassurance and explanation when it's actually not worth pursuing what looks like a worrisome number (matter-of-factly or touchy-feely both serve the purpose well, in my opinion). My most rec

How utterly frustrating for that lady. How rude of the medical people to have her sit for such a long long long time without a howdyado etc.
Now wonder I am totally disillusioned and not only that also with medicines that have so many terrible side effects which makes you sicker.
I think if a dr doesnt do her most basic of skills or treatment for a one on one with a patient then its time to move on and find a Dr who has a good level of patient concern,
Dont put up with a modicum of service b/c if you went to a restaurant and the service was poor as was the food, then you 'd never go back and you would find another restaurant, wouldnt you?
I get so fed up, honestly.

I love my doctor, he is being taking care of me for the past 26 years and my family, said this as a patient, and putting my doctor aside, I must say that SOME doctors can be some how bipolar, yes bipolar. They have one personality with their patients, and have the God/evil attitude with the people who works for them, even if the success in their careers rest IN GREAT PART on the people who provide them with all the information needed about their PT's. since SOME of them just see the patient for a few minutes, while the nursing department gets them most of the information, this in the hospital environment.

Oh my. I truly feel for those patients that are trying to get the expert care they need and many times don't. On the doctor side, my doctor and medical assistant seem to have a great professional relationship, but I have witnessed disrepect between a dentist that became inpatient with his assistant and each time I came that month you could see the stress mounting on her. Thanks for the eye-opening post.